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EL-13-1590Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FIL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 195347 Scheduled Inspection Date: December 06, 2013 Inspector: Devaney, Michael Owner: THERMITUS, GRACIA Job Address: 225 NW 91 Street Miami Shores, FL 33150- Project: <NONE> Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Building Department Comments Permit Number: EL -7 -13 -1590 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010331350 Phone: (305)968 -7832 . _ ELECTRICAL WORK FOR KITCHEN REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 05, 2013 For Inspections please call: (305)762 -4949 Page 8 of 24 Miami Shores Village Building Department 10050 N Elnd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERNUT APPLICATION Permit Type: Electrical JOB ADDRESS: 5 FBC 2010 ,=0a��. JUL 16 21313 Permit No. -r— o J 0 Master Permit No. FC2 A .- � -1- ' City: Miami Shores County. Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: liame (Fee Simple Titleholder): Address• 5 Q \ �- city. R Lt M a State: Tenant CONTRACTOR: Company Name: Address: A q'7 -5-0 S . , City mi a" cl rbl .1 State: Zip: 3267 Qualifier Name: �_� d✓+ v e ®n r� `1 6 ®v ,n0 Phone#: 64=2 State Certification or Registration #: / ) 0 / --) -�' –) (0 Contact Phone #: 3-268-233z- Email Address• Certificate of Competency #: DESIGNER: Architect /Engineer: Phone #: Value of Work for this Permit: $ � C? y . C.) (D square/Linear Footage of Work: Type of Work: ❑Address [_ration ONew ODemolition Description oof� Work: �jN �r�- % � t C —r; G; 0 � � % � � s C" t✓ & 4 /� Il ' Cidi C�d6/ Submittal Fee $ Permit Fee $ �✓' ' CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ ° SA Bonding Company's Name (if applicable) Bonding Company's Address City' State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip Application is hereby made -to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction,in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. I Owner or Agent Signature Al Contractor The foregoing instrument was acknowledged before me this `� The foregoing instrument was acknowledged before me this day of'___, 20 B3 byjq�� -� day ofd �� 20, by rJ !r who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. Sign: "�' ��v f : ��-,�°wc�i Sign: Print _� > �'� 23. • y Print: My Commission Exp g ® ®® e My C 6. #D �ratra�rskvraY�r�r�r, 8dr�tr9FaYsk�trdr& aYa��' a\ �r? �a�traYSrs Y, lr�lraY& �r�tr+ ktatraYdr &de�tr,He�rardr &a�edeeYie�tr, APPROVED BY Plans Examiner and who did take an oath. )953828 �R: � astSm�;:+�Q�` STATEDF � ..x%11% Zoning Structural Review Clerk A (Revised 3 /112012)(Revised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09) THIS IS NOT A BILL — DO NOT PAY 556799-6 RENEWAL BUSINESS HME / LOCATM RECEI" NO. 580797-0 ALL QUALITY ELECTRICAL SERVICES CC # OSE000478 - INC 14750-S RIVER DR 33167 UNIN DADE COUNTY OWNER ALL QUALITY ELECTRICAL SVCS INC WUKF*tK/'.b CONTRACTOR I DO NOT FORWARD ALL QUALITY ELECTRICAL SERVICES INC SAMUEL LiUnINUUKHE rKtZo PAYRAIM VX40M 14750 S RIVER DR UJAW-DAM COIJIM cas�caoaaTA" MIAMI FL 33167 01/24/2013 02220018001 111111, 000093.75 SEE MER SIDE W.1=1 I I I a Report Viewer 0 a m 0r1 r, a I F—w-% . " CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKEW CONIPENSATION LAW" CONSTRUCTION INDUSTRY EXEMP71ON This Certifies that the McMdual fisted below has eleded to be exempt from FlorWa Workers' Compesation law. EFFECTIVE DATE: 812112013 EXPIRATION DATE: 6M=15 PERSON: LIGHTBOURNE SAMUEL FEIN: 542171753 BUSINESS NAME AND ADDRESS: ALL QUALITY ELECTRICAL SERVICES INC 14750 S. RIVER DRIVE MIAMI FL 33187 SCOPES OF BUSINESS OR TRADE: ELECTRICAL WIRING BURGLAR AND FIRE WITHIN BUIL ALARM INSTALL W DF8-P2- DWG252 CERTIFICATE OF ELECMON TO BE EXEMPT REMSED 07 -12 QlJBSMONS? @50)413.18W Page 1 of 1 https:llapps8 -fldfs. corn lcrreporMewerlreportViewer.aspx ?data= kdvpginc9D7Q3gH6TER6... 7/12/2013 °r CERTIFICATE OF ❑ABILITY INSURANCE `.... -� DATE(AAMlDD/YY) 04/22/13 PRODUCER Annetta Willis insurance 18401 N.W. 27 Ave Miami, FL 33056 Phone (305) 625 -2403 Fax (305) 625 -6472 EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICI ES BELOW. INSURERS AFFORDING COVERAGE NAIC 11: INSURED ALL QUALITY ELECTRICAL SERVICES, INC AND SAMUEL LIGHTBOURNE 14750 SOUTH RIVERS DRIVE MIAMI, FL. 33167 10050 NE 2ND AVENUE INSURER A: WESTERN HERITAGE 00601 INSURER e: PROGRESSIVE EXPRESS INS CO 11760 INSURER C: INSURER D: INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED PAID CLAIMS. ADD'L TYPE OF INSURANCE POLICY NUltl1BER D pA�cY OMMIMM ��w LIA�ITS FTR ❑ GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS MADE ® OCCUR ❑ SCP0939393 04/16/1.3 04/16/14 EACH OCCURRENCE 1,000,0w PREMISES a oa,ureence `50.� MED EXP (Any one person) 5,000 PERSONAL & ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 2,OMOW GEN'L AGGREGATE LIMT APPLIES PER: ® POLICY ❑ PROJECT ❑ LOC PRODUCTS - COMPIOP AGG 1,000,000 B ❑ AUTOMOBILE LIABILITY El ANYAUTO © ALL OWNED AUTOS © SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS ❑ 01961394 -0 11/29/12 11/29 /13 COMBINED SINGLE LIMIT (Eaa«ddent) 100,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per a«ident) El ❑ GARAGE LIABILITY ❑ ANY AUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG ❑ F-XCESSIUMBRELLA LIABILITY LJ1 OCCUR (_� CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ EACH OCCURRENCE AGGREGATE C WORKERS COMPENSATION AND LIABILITY ANY PROPRIETOR I PARTNER I EXECUTIVE OFFICER I MEMBER EXCLUDED? N yes, dew under SPECIAL PROVISIONS below ®W STATU- El T E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS. ELECTRICAL WORK CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009 /oB) QF @ ACORD CORPORATION 1986 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE .THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL MIAMI SHORES VILLAGE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO BUILDING DEPARTMENT- THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY 10050 NE 2ND AVENUE OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE MIAMI SHORES, EL 33138 ACORD 25 (2009 /oB) QF @ ACORD CORPORATION 1986